The development of kidney stones is certainly a concern if you’re switching to a diet in which you’re eating more protein.
(Though, again, the keto diet is more of a moderate-protein diet.) “Consuming high levels of red meat and not drinking a lot of water may make stones more likely,” says Whitmire.
She adds that on a keto diet, you need to stay hydrated and replenish electrolytes (minerals like sodium, potassium, magnesium, and calcium). “If not, this can increase your risk of side effects like stones,” she says.
Past research gives a small glimpse into how likely stones may be. A study published in the Journal of Child Neurology on children using the keto diet to control epilepsy found that about 1 in 15 developed kidney stones, though supplements of oral potassium citrate reduced this risk.
Talk to your doctor if you have risk factors, like a family or personal history of stones, about any precautions you should take when on the keto diet.